TI RN MENTAL HEALTH
A
PROCTORED 2026-2027 | Exam
Questions & Answers | Verified
Answers | Latest Edition | Pass
Guaranteed - A+ Graded
[DOMAIN 1: MOOD DISORDERS (DEPRESSION, BIPOLAR DISORDER) - 60 Questions]**
### **Major Depressive Disorder (MDD)**
* *Question 1**
A nurse is assessing a client admitted with major depressive disorder. Which statement by the
client indicates clinical depression rather than normal grief?
. "I miss my spouse every day, but I still enjoy spending time with my grandchildren."
A
B. "I cry when I think about my loss, but I can still concentrate on my daily tasks."
C. "I don't feel anything but numbness anymore; even my favorite activities bring no joy."
D. "I feel sad about the divorce, but I know I'll eventually move forward with my life."
* *Rationale:** Clinical depression is characterized by pervasive anhedonia (inability to
experience pleasure), emotional numbness, and persistent symptoms that interfere with
functioning. Normal grief involves sadness but preserves the capacity for positive emotions and
future-oriented thinking. Option C demonstrates anhedonia and emotional flattening—hallmark
features of MDD per DSM-5-TR criteria. Options A, B, and D all indicate adaptive grief
responses with preserved functioning and hope. **[CORRECT: C]**
---
* *Question 2**
A client with severe depression suddenly appears cheerful, energetic, and gives away prized
possessions to fellow patients. What is the nurse's priority action?
. Document the mood improvement as positive treatment response
A
B. Assess the client immediately for suicidal ideation, plan, and intent
, . Encourage the client to share their improved mood in group therapy
C
D. Contact the family to report the client's dramatic improvement
* *Rationale:** Sudden mood improvement in severely depressed clients is a critical warning
sign of impending suicide risk. This phenomenon occurs when a client makes the decision to
complete suicide, experiencing relief and renewed energy to carry out the plan. Giving away
possessions is a classic behavioral indicator of suicide preparation. The nurse must conduct
immediate reassessment of suicidal ideation, plan, and intent using direct, non-judgmental
questioning. Documentation (A) without assessment is dangerous; group sharing (C) is
premature; family contact (D) violates confidentiality without client consent. **[CORRECT: B]**
---
* *Question 3**
A client receiving fluoxetine (Prozac) for depression asks when they should expect to feel better.
What is the nurse's best response?
. "You should notice significant improvement within 3-5 days of starting the medication."
A
B. "Full therapeutic effects typically take 6-8 weeks; contact your provider if no improvement
after 6 weeks."
C. "Most clients feel completely cured within 2 weeks of consistent dosing."
D. "The medication works immediately, but you may not recognize the changes yourself."
* *Rationale:** SSRIs like fluoxetine require 6-8 weeks for full therapeutic effect due to the time
needed for neuroadaptive changes in serotonin receptor sensitivity and downstream signaling
pathways. Early activation (increased energy) may occur before mood improvement,
paradoxically increasing suicide risk in the first 2 weeks. If no response occurs after 6-8 weeks
at therapeutic dose, the provider should evaluate for dose adjustment, augmentation, or
medication switch. Options A, C, and D present dangerously inaccurate timelines that could
lead to premature discontinuation or false expectations. **[CORRECT: B]**
---
* *Question 4**
A client with depression tells the nurse, "I've given away all my jewelry to my friends because I
won't need it anymore." What is the nurse's therapeutic response?
. "That's very generous of you to give your belongings away."
A
B. "Are you thinking about hurting yourself?"
C. "You should keep your valuables for when you return home."
D. "Did your friends appreciate the gifts you gave them?"
* *Rationale:** Giving away possessions is a behavioral warning sign for suicide risk. ATI
emphasizes direct assessment of suicidal ideation using clear, unambiguous language. Option
, follows the therapeutic communication principle of addressing the underlying concern directly
B
rather than avoiding the topic. Option A reinforces dangerous behavior; Option C is
non-therapeutic and dismissive; Option D deflects from the critical safety issue. The nurse must
assess for suicidal ideation, plan, means, and intent immediately. **[CORRECT: B]**
---
* *Question 5**
Which finding indicates to the nurse that a client with depression requires immediate
intervention?
. The client reports difficulty falling asleep but sleeps 6 hours nightly.
A
B. The client has unkempt appearance, social withdrawal, and reports 2 weeks of anhedonia.
C. The client expresses hopelessness and has developed a specific suicide plan.
D. The client reports decreased appetite with 5-pound weight loss over 1 month.
* *Rationale:** While all options indicate depressive symptoms, Option C represents an imminent
safety threat requiring immediate intervention. A specific suicide plan with expressed
hopelessness indicates high lethality. The SAD PERSONS scale identifies plan, access to
means, and expressed intent as critical risk factors. Options A, B, and D require monitoring and
intervention but do not indicate immediate life-threatening risk. The nurse must implement
constant observation, remove potential means, and notify the provider immediately.
**[CORRECT: C]**
---
* *Question 6**
A nurse is teaching a client preparing for electroconvulsive therapy (ECT) for severe
depression. Which statement by the client indicates understanding of post-treatment
expectations?
. "I expect to feel completely cured after my first treatment."
A
B. "Confusion and memory loss after treatment are expected; my nurse will orient me
frequently."
C. "I will be able to drive myself home immediately after the procedure."
D. "ECT works by implanting electrical devices in my brain."
* *Rationale:** Post-ECT confusion and anterograde/retrograde amnesia are expected
temporary effects due to the seizure activity and anesthesia. Frequent orientation and
reassurance are standard nursing interventions. ECT typically requires 6-12 treatments for
therapeutic effect (not immediate cure in one session—A is incorrect). Clients cannot drive or
operate machinery for 24-48 hours post-treatment due to anesthesia and cognitive effects (C is
incorrect). ECT induces a controlled seizure; no devices are implanted (D is incorrect).
**[CORRECT: B]**
, ---
* *Question 7**
Which risk factor places a client at highest priority for suicide assessment?
. 65-year-old male with recent retirement and social support
A
B. 25-year-old female with depression, recent job loss, and access to firearms
C. 45-year-old male with diabetes mellitus and stable mood disorder
D. 30-year-old female with anxiety disorder and strong religious beliefs
* *Rationale:** The SAD PERSONS scale identifies male gender, depression, recent loss, and
access to lethal means as cumulative risk factors. Firearm access dramatically increases
suicide lethality (85-90% completion rate with firearms vs. 5% with overdose). While diabetes
(C) is a risk factor per SAD PERSONS, it is lower priority than acute depression with means.
Religious beliefs (D) may be protective. Social support (A) is protective despite age and
retirement. **[CORRECT: B]**
---
* *Question 8**
A nurse is planning care for a client with depression. Which intervention should the nurse
prioritize to promote recovery?
. Encourage the client to stay in bed and rest as much as possible
A
B. Encourage physical activity during daylight hours and establish a sleep-wake routine
C. Allow the client to skip meals if they lack appetite to avoid conflict
D. Discourage social interaction until the client expresses interest spontaneously
* *Rationale:** Physical activity increases brain-derived neurotrophic factor (BDNF), serotonin,
and norepinephrine—neurobiological mechanisms that support antidepressant effects. Daylight
exposure helps regulate circadian rhythms and melatonin secretion, improving sleep
architecture. Structured routines counteract the behavioral inertia of depression. Option A
promotes deconditioning and social isolation; Option C risks nutritional deficits and metabolic
complications; Option D prolongs isolation when therapeutic engagement is needed.
**[CORRECT: B]**
---
* *Question 9**
A client taking fluoxetine (Prozac) reports sexual dysfunction and insomnia. What is the nurse's
best action?
A. Instruct the client to discontinue the medication immediately
A
PROCTORED 2026-2027 | Exam
Questions & Answers | Verified
Answers | Latest Edition | Pass
Guaranteed - A+ Graded
[DOMAIN 1: MOOD DISORDERS (DEPRESSION, BIPOLAR DISORDER) - 60 Questions]**
### **Major Depressive Disorder (MDD)**
* *Question 1**
A nurse is assessing a client admitted with major depressive disorder. Which statement by the
client indicates clinical depression rather than normal grief?
. "I miss my spouse every day, but I still enjoy spending time with my grandchildren."
A
B. "I cry when I think about my loss, but I can still concentrate on my daily tasks."
C. "I don't feel anything but numbness anymore; even my favorite activities bring no joy."
D. "I feel sad about the divorce, but I know I'll eventually move forward with my life."
* *Rationale:** Clinical depression is characterized by pervasive anhedonia (inability to
experience pleasure), emotional numbness, and persistent symptoms that interfere with
functioning. Normal grief involves sadness but preserves the capacity for positive emotions and
future-oriented thinking. Option C demonstrates anhedonia and emotional flattening—hallmark
features of MDD per DSM-5-TR criteria. Options A, B, and D all indicate adaptive grief
responses with preserved functioning and hope. **[CORRECT: C]**
---
* *Question 2**
A client with severe depression suddenly appears cheerful, energetic, and gives away prized
possessions to fellow patients. What is the nurse's priority action?
. Document the mood improvement as positive treatment response
A
B. Assess the client immediately for suicidal ideation, plan, and intent
, . Encourage the client to share their improved mood in group therapy
C
D. Contact the family to report the client's dramatic improvement
* *Rationale:** Sudden mood improvement in severely depressed clients is a critical warning
sign of impending suicide risk. This phenomenon occurs when a client makes the decision to
complete suicide, experiencing relief and renewed energy to carry out the plan. Giving away
possessions is a classic behavioral indicator of suicide preparation. The nurse must conduct
immediate reassessment of suicidal ideation, plan, and intent using direct, non-judgmental
questioning. Documentation (A) without assessment is dangerous; group sharing (C) is
premature; family contact (D) violates confidentiality without client consent. **[CORRECT: B]**
---
* *Question 3**
A client receiving fluoxetine (Prozac) for depression asks when they should expect to feel better.
What is the nurse's best response?
. "You should notice significant improvement within 3-5 days of starting the medication."
A
B. "Full therapeutic effects typically take 6-8 weeks; contact your provider if no improvement
after 6 weeks."
C. "Most clients feel completely cured within 2 weeks of consistent dosing."
D. "The medication works immediately, but you may not recognize the changes yourself."
* *Rationale:** SSRIs like fluoxetine require 6-8 weeks for full therapeutic effect due to the time
needed for neuroadaptive changes in serotonin receptor sensitivity and downstream signaling
pathways. Early activation (increased energy) may occur before mood improvement,
paradoxically increasing suicide risk in the first 2 weeks. If no response occurs after 6-8 weeks
at therapeutic dose, the provider should evaluate for dose adjustment, augmentation, or
medication switch. Options A, C, and D present dangerously inaccurate timelines that could
lead to premature discontinuation or false expectations. **[CORRECT: B]**
---
* *Question 4**
A client with depression tells the nurse, "I've given away all my jewelry to my friends because I
won't need it anymore." What is the nurse's therapeutic response?
. "That's very generous of you to give your belongings away."
A
B. "Are you thinking about hurting yourself?"
C. "You should keep your valuables for when you return home."
D. "Did your friends appreciate the gifts you gave them?"
* *Rationale:** Giving away possessions is a behavioral warning sign for suicide risk. ATI
emphasizes direct assessment of suicidal ideation using clear, unambiguous language. Option
, follows the therapeutic communication principle of addressing the underlying concern directly
B
rather than avoiding the topic. Option A reinforces dangerous behavior; Option C is
non-therapeutic and dismissive; Option D deflects from the critical safety issue. The nurse must
assess for suicidal ideation, plan, means, and intent immediately. **[CORRECT: B]**
---
* *Question 5**
Which finding indicates to the nurse that a client with depression requires immediate
intervention?
. The client reports difficulty falling asleep but sleeps 6 hours nightly.
A
B. The client has unkempt appearance, social withdrawal, and reports 2 weeks of anhedonia.
C. The client expresses hopelessness and has developed a specific suicide plan.
D. The client reports decreased appetite with 5-pound weight loss over 1 month.
* *Rationale:** While all options indicate depressive symptoms, Option C represents an imminent
safety threat requiring immediate intervention. A specific suicide plan with expressed
hopelessness indicates high lethality. The SAD PERSONS scale identifies plan, access to
means, and expressed intent as critical risk factors. Options A, B, and D require monitoring and
intervention but do not indicate immediate life-threatening risk. The nurse must implement
constant observation, remove potential means, and notify the provider immediately.
**[CORRECT: C]**
---
* *Question 6**
A nurse is teaching a client preparing for electroconvulsive therapy (ECT) for severe
depression. Which statement by the client indicates understanding of post-treatment
expectations?
. "I expect to feel completely cured after my first treatment."
A
B. "Confusion and memory loss after treatment are expected; my nurse will orient me
frequently."
C. "I will be able to drive myself home immediately after the procedure."
D. "ECT works by implanting electrical devices in my brain."
* *Rationale:** Post-ECT confusion and anterograde/retrograde amnesia are expected
temporary effects due to the seizure activity and anesthesia. Frequent orientation and
reassurance are standard nursing interventions. ECT typically requires 6-12 treatments for
therapeutic effect (not immediate cure in one session—A is incorrect). Clients cannot drive or
operate machinery for 24-48 hours post-treatment due to anesthesia and cognitive effects (C is
incorrect). ECT induces a controlled seizure; no devices are implanted (D is incorrect).
**[CORRECT: B]**
, ---
* *Question 7**
Which risk factor places a client at highest priority for suicide assessment?
. 65-year-old male with recent retirement and social support
A
B. 25-year-old female with depression, recent job loss, and access to firearms
C. 45-year-old male with diabetes mellitus and stable mood disorder
D. 30-year-old female with anxiety disorder and strong religious beliefs
* *Rationale:** The SAD PERSONS scale identifies male gender, depression, recent loss, and
access to lethal means as cumulative risk factors. Firearm access dramatically increases
suicide lethality (85-90% completion rate with firearms vs. 5% with overdose). While diabetes
(C) is a risk factor per SAD PERSONS, it is lower priority than acute depression with means.
Religious beliefs (D) may be protective. Social support (A) is protective despite age and
retirement. **[CORRECT: B]**
---
* *Question 8**
A nurse is planning care for a client with depression. Which intervention should the nurse
prioritize to promote recovery?
. Encourage the client to stay in bed and rest as much as possible
A
B. Encourage physical activity during daylight hours and establish a sleep-wake routine
C. Allow the client to skip meals if they lack appetite to avoid conflict
D. Discourage social interaction until the client expresses interest spontaneously
* *Rationale:** Physical activity increases brain-derived neurotrophic factor (BDNF), serotonin,
and norepinephrine—neurobiological mechanisms that support antidepressant effects. Daylight
exposure helps regulate circadian rhythms and melatonin secretion, improving sleep
architecture. Structured routines counteract the behavioral inertia of depression. Option A
promotes deconditioning and social isolation; Option C risks nutritional deficits and metabolic
complications; Option D prolongs isolation when therapeutic engagement is needed.
**[CORRECT: B]**
---
* *Question 9**
A client taking fluoxetine (Prozac) reports sexual dysfunction and insomnia. What is the nurse's
best action?
A. Instruct the client to discontinue the medication immediately
